obsessive-compulsive disorder; OCD

Size: px

Start display at page:

Download "obsessive-compulsive disorder; OCD"

Isabella Morrison
5 years ago
Views:

1 9(1), 50 56, 2017 OCD OCD DBSECT tdcsrtms DBS ECT 6 tdcs rtms obsessive-compulsive disorder; OCD 2013 OCD 2012 deep brain stimulation; DBS electroconvulsive therapy; ECT transcranial direct current stimulation; tdcs repetitive transcranial magnetic stimulation; rtms OCD OCD cortico-striato-thalamocortical; CSTCFigure 1 50

2 Figure 1 cortico-striatothalamo-cortical; CSTC DBS DBS DBS DBS 1990 OCD DBS DBS 2009 humanitarian device exemption OCD U.S. Food Drug and Administration, 2017 on/off DBS DBS CSTC OCD 2017b DBS ECT ECT OCD ECT 2007 Fontenelle OCD ECT Fontenelle et al., 2015 ECT OCD ECT OCD American Psychiatric Association; APA ECT DBS ECT 51

3 Vol. 9 No. 1 ECT ECT OCD OCD ECT ECT 2007 tdcs tdcs 1 2 ma tdcs 2015 tdcs 2015 OCD tdcs D Urso 12 OCD 2 ma, OCD D Urso et al., 2016 rtms SMA rtms rtms tdcs rtms Hz 1 Hz dorsolateral prefrontal cortex; DLPFC DLPFC rtms a rtms

4 Table 1 Zhou et al., 2017 Hedge s g Hedge s g DLPFC Cheng, Ma, Haghighi, Jahangard, Zhang, DLPFC Sachdev, Luo, DLPFC Alonso, Tang, Zhang, Mansur, Han, Elbeh, 2016a Elbeh, 2016b Seo, DLPFC SMA Kang, OFC Ruffini, Nauczyciel, SMA Mantovani, Hawken, Pelissolo, Hz Hz Hz Y-BOCS Y-BOCS DLFPC; OFC; SMA; Y-BOCS; Yale-Brown 53

5 Vol. 9 No rtms 8, , b OCD rtms rtms 2 cm OCD DLPFC orbitofrontal cortex; OFC supplementary motor area; SMA OCD CSTC Milad ventral affective circuit OFC ventral cognitive circuitdlfpc dorsal cognitive circuit Milad & Rauch, 2012 goal-directed behavior habitual behavior SMA 4 CSTC OCD SMA rtms van den Heuvel et al., 2016; 2017a Zhou 20 N 791 Hedge s g ; p rtms OCD Table 1 Zhou et al., 2017 rtms Hedge s gdlpfc g 0.65, , p DLPFC g 0.47, , p 0.02 DLPFC g 0.93, , p 0.001SMA g 0.56, ; p OFC g 0.56, , p Hz 1 Hz OCD Zhou OCD rtms OCD rtms 2017 OCD DBS ECT 6 54

6 tdcs rtms D Urso, G., Brunoni, A. R., Mazzaferro, M. P., Anastasia, A., de Bartolomeis, A., & Mantovani, A. (2016). Transcranial direct current stimulation for obsessive-compulsive disorder: A randomized, controlled, partial crossover trial. Depress Anxiety, 33, Fontenelle, L. F., Coutinho, E. S., Lins-Martins, N. M., Fitzgerald, P. B., Fujiwara, H., & Yucel, M. (2015). Electroconvulsive therapy for obsessivecompulsive disorder: a systematic review. J Clin Psychiatry, 76, rtms 117, aTMS TMS pp b rtms TMS pp rtms 32, Milad, M. R. & Rauch, S. L. (2012). Obsessive-compulsive disorder: Beyond segregated cortico-striatal pathways. Trends Cogn. Sci., 16, , a compulsivity 32, b DBS 32, , ECT 22, tdcs 21, 18, U.S. Food and Drug Administration (2017). Humanitarian Device Exemption (HDE) accessdata.fda.gov/scripts/cdrh/cfdocs/cfhde/hde. cfm?id H ( ) van den Heuvel, O. A., van Wingen, G., Soriano-Mas, C., Alonso, P. Chamberlain, S. R., Nakamae, T., Denys, D., Goudriaan, A. E., & Veltman, D. J. (2016). Brain circuitry of compulsivity. Eur. Neuropsychopharmacol., 26, Zhou, D. D., Wang, W., Wang, G. M., Li, D. Q., Kuang, L. (2017). An updated meta-analysis: Short-term therapeutic effects of repeated transcranial magnetic stimulation in treating obsessivecompulsive disorder. J. Affect Disord., 215,

7 Vol. 9 No. 1 Neuromodulation for Obsessive-Compulsive Disorder Takashi Nakamae Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine Abstract Many treatment strategies including neuromodulation have been proposed for obsessive compulsive disorder (OCD) patients who do not respond to conventional pharmacotherapy and behavioral therapy. Neuromodulation that could be effective for OCD includes deep brain stimulation (DBS), electroconvulsive therapy (ECT), transcranial direct current stimulation (tdcs), and repetitive transcranial magnetic stimulation (rtms). Invasiveness, target brain regions, efficacy and adverse events of each treatment were reviewed in this article. DBS could be effective for half of patients with severe and refractory OCD, while it is invasive therapy. ECT will bring some sort of good effect for 60 of patients with OCD, while there is no randomized controlled study so far. tdcs is non-invasive neuromodulation, but the number of clinical trials is low. Finally, rtms have been well investigated and some meta-analyses showed its efficacy, but the optimal setting is still unknown. As there are advantages and disadvantages for each treatment, further research is needed. Key Words: deep brain stimulation, neuromodulation, obsessive compulsive disorder, repetitive transcranial magnetic stimulation 56

Simone Rehn 1,2 & Guy D. Eslick 3 & Vlasios Brakoulias 4

Simone Rehn 1,2 & Guy D. Eslick 3 & Vlasios Brakoulias 4 https://doi.org/10.1007/s11126-018-9566-7 REVIEW ARTICLE A Meta-Analysis of the Effectiveness of Different Cortical Targets Used in Repetitive Transcranial Magnetic Stimulation (rtms) for the Treatment